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GROUP VISIT REQUEST FORM

To submit your request to the Marian Koshland Science Museum, please complete the following form and click submit. Your form has been received when you see the confirmation page.

Required fields are starred.

Organization/Company/School Name *

Contact Name *

Contact Title *

Address *

Address (cont'd)

City *

State *

ZIP *

Phone *

Fax

Email *

PLEASE NOTE - At this time we cannot accept group visit requests for any date after November 22, 2017. Please list below, in order of preference, the date and time your group would like to visit.

Date 1 *

Month

Day

Year

Times

1 *

Hour

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Minute

am

pm

2 *

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Minute

am

pm

3

Hour

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Minute

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pm

Date 2

Month

Day

Year

Times

1

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pm

2

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pm

3

Hour

:

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Date 3

Month

Day

Year

Times

1

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am

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Name of group

If different from above

Name of contact to arrive with group

If different from above

Number of adults *

Number of students *

Grade level *

Please indicate the type of group visit you would like: *

Self-guided

Facilitated

Self-guided: 12-100 participants tour all exhibits - Facilitated: 12-36 participants tour one exhibit (additional fee of $200 applies unless you are a middle or high school group from the Washington, DC Metro Area)

Self-guided visit options

A brief welcome to the museum

Orientation to the museum and select exhibit highlights

Worksheets

If you selected a self-guided visit, you may select any of the options above.

Facilitated visit option

Earth Lab

Life Lab

If you selected a facilitated visit, choose either the Earth Lab or the Life Lab exhibit.

Does your group have a specific area of interest for exhibit explorations?

Does your group require any special accommodations?

Verification *

Type the characters you see in the picture; if you can't read them, submit the form and a new image will be generated. Not case sensitive. Switch to audio verification.